Online Program

HIV infection and development of diabetes in a cohort of men receiving care from a large urban community-based health center

Sunday, November 1, 2015

Grant Farmer, PhD, MPH, Department of Surgery, Washington University in St. Louis School of Medicine, Division of Public Health Sciences, St. Louis, MO
Deborah Bowen, PhD, Bioethics and Humanities, University of Washington, Seattle
Thomas Burroughs, PhD, Center for Outcomes Research (SLUCOR), Saint Louis University, St. Louis, MO
Kathleen K. Bucholz, PhD, MPH, Department of Psychiatry, Midwest Alcoholism Research Center, Washington University School of Medicine, St. Louis, MO
Louise H. Flick, DrPH, MPE, MSN, Department of Epidemiology, Saint Louis University, College of Public Health & Social Justice, St Louis, MO
Kenneth H. Mayer, MD, Harvard Medical School, Beth Israel Deaconess Medical Center, Boston, MA
Background:Antiretroviral therapy has resulted in fewer AIDS-related deaths among persons living with HIV. However, this reduction has been accompanied by increases in morbidity and mortality from non-AIDS related diseases, including diabetes. To assess the incidence of diabetes in a contemporary clinical care environment, the present study examined diabetes incidence among HIV-infected and uninfected men engaged in primary care at a large urban community-based health center.

Methods: From 2001 to 2002, participants completed a brief survey assessing sociodemographic characteristics and health behaviors. Responses were linked to electronic medical records, and outcome information was extracted from the survey date until December 31, 2012. Proportional hazards models were used to estimate the association between HIV infection and development of diabetes before and after controlling for covariates.

Results: Of the 1058 study participants, 189 (17.9%) were HIV-infected at baseline. Significant (p<0.05) differences were observed on a number of sociodemographic characteristics, health behaviors and health outcomes by HIV status. Proportionally more HIV-infected participants developed diabetes during the follow-up period than HIV-uninfected participants (5.03% vs. 1.15% respectively, p<0.001); however, HIV infection was not associated with time to diabetes diagnosis in either the unadjusted (hazard ratio [HR]=1.23, 95% confidence interval [CI]: 0.50, 3.00), or adjusted model (HR=1.89, 95% CI: 0.70, 5.10). 

Conclusions: We did not find an association between HIV infection and development of diabetes in our cohort, despite observing proportionally more diabetes diagnoses among our HIV-infected participants. These contradictory findings suggest future research is needed in this area with a larger and more diverse sample.  

Learning Areas:

Chronic disease management and prevention

Learning Objectives:
Identify possible factors for increased diabetes incidence among HIV-infected persons Discuss the relationship between the availability of antiretroviral therapy and increases in chronic disease among persons living with HIV Differentiate between adjusted and un-adjusted measures of disease risk

Keyword(s): HIV/AIDS, Diabetes

Presenting author's disclosure statement:

Qualified on the content I am responsible for because: I am a researcher with experience in the area.
Any relevant financial relationships? No

I agree to comply with the American Public Health Association Conflict of Interest and Commercial Support Guidelines, and to disclose to the participants any off-label or experimental uses of a commercial product or service discussed in my presentation.